ER (1994–2009): Season 10, Episode 17 - The Student - full transcript

Previously on E.R.

If it's a choice
between something serious

or nothing,

maybe serious is the way to go.

You still on for
dinner tonight?

Looks like you're
dating a teacher.

I am.

You take care, big man.

Please don't go.

I'm going to have a baby,
and Chuck's the father.

You're going
to be a grandpa.



You're marrying her?

If she'll have me.

That's it.

Hey, what is that?

Little bit
of Sikh rap.

Wait a minute.
He's stable now.

He'll be fine.
I know, but just...

If I don't get out of here,

I'm going to lose it.
Do you understand?

Kertzenstein, Lester.

Lester.

Lester, Lester, Lester...

Very polite.

Hmm. He should try pathology.



Yeah. That way, his
patients will be dead

before he gets to them.

I heard
he wants radiology anyway.

Second tier.
Lockhart, Abby.

Very strong
clinical skills.

Efficient when she needs to be.

Knows where to spend her time.

The only person
who's not sure

about Abby is Abby.

Does she want
Emergency Medicine?

As much as she wants anything.

WEAVER:
All right.

Rank to match.

Rasgotra, Neela.

Intelligent,
very sweet.

Studious.

Studious?

She's the smartest one
on the floor.

Come on.

She could be
more assertive.

CHEN:
She has a tendency
to hang back,

avoid getting into traumas.

She's cautious. That's good.

LEWIS:
She's not ER.

She'll be

a star in internal medicine,
or research--

something using
your intellect--

but she's not an ER doc.

Uh, since when
did intellect become a liability

to working in the ER?

WEAVER:
There was a memo

while you were in Africa.

I think she's excellent.

She basically saved
Frank's life.

She's thoughtful, yeah,
but she's deliberate.

Is that code
for passive and slow?

She's a student.

She's going to get faster.

LEWIS:
Yeah, and in
four months,

she'll be a doctor.

I say rank to match.

That's not the consensus.

Consensus is wrong.

WEAVER:
Okay.

The NRMP list doesn't have
to go out right away.

Carter, change our minds.

Well, at least
you have some time

for your
reclamation project.

Not really. I'm on a plane
to Africa tonight.

For how long?

About a week or so.

How's Kem doing?

She's pregnant.

She asked me to fill
a suitcase with Ho-Hos.

Yeah. Save some for me.

I need you to sign
off on these dispos?

My shift's over.

14 hours isn't enough?

Dr. Carter, 27-year-old
healthy male,

knee versus circular saw.

Chuck said he'd be
waiting for you outside.

Chivalry-- time of death, 8:07.

How long has he been here?

Sat in triage
for seven hours,

and back in a room
for the last two.

Good luck, Carter.

Um, you irrigated, yeah?

I was concerned

that the lac might extend
to the joint.

For nine hours?

Well, I thought
I should wait on you.

You think Ike's
serving burgers
this early?

I really
need a burger.

What is up with you?

I think we've
got a case

of, uh, sympathetic
pregnancy going on here.

Excuse me?

I have all the
symptoms-- nausea, gas,

increased salivation,
cravings.

I got to pee
all the time.

You had all that
before I got pregnant.

You know what?
I have to sit down.

Just get me whatever
you're getting, okay?

All right. See?

We're together in this.

( sighs ):
Oh.

Morning.

Morning.

When are you due?

Oh, another month or so.

I love kids.

When my wife was
pregnant with ours,

it was... it was
the best thing ever.

Yeah, it's pretty great.

Yeah. We're divorced now.

Oh, I'm sorry.

Women are never more beautiful
than when they're pregnant.

( laughs ):
Ooh.

I wish it felt that way.

Hey...

don't let anyone ever
tell you you're not sexy.

Because you are sexy.

Thank you.

Any real man

knows that
there's nothing better

than making love
to a round, smooth,

nurturing, mother-to-be.

I-I hope you don't take that
the wrong way.

There's a right
way to take that?

I didn't mean to offend you.

You know what?
It's okay.

Can I touch it?

Excuse me?

Your belly-- can I touch it?

CHUCK:
Whoa, hey,
what's going on?

You know what?
We need to go.

What are you doing?

I was just talking to the lady.

He wanted to
touch my belly.
Was he hitting on you?

Ease up, pal. I don't see a ring
on her finger.

Oh.

( grunts )

Whoa.

Oh, God, my lip.

Must be the hormones.

It was flagrant assault.

I already called the cops.

My lawyer's
on the way.
You molested me first.

I asked you
an innocent question.

It was not innocent.

That caveman decked me
for exercising

my freedom of speech.

Sit still. As long
as I'm stitching your lip,

you have no freedom of speech.

He was defending me.

You didn't need

defending.

I was just being friendly.

KOVAC:
Order a
nasal series

and let me know when
his X rays are back.

Aah! What a creep.

Chuck could have
punched him
in his teeth.

That way, they
can't talk.

Did he apologize?

No, but he
called the cops.

To what,
to turn himself in?

No. Come on, we have
to have a little chat.

TAGGART:
Oh, no, I understand.

Yeah, have a great time.

Yeah, next weekend.

Good morning.

Hey there.

What's wrong?

Oh, it's Alex's
birthday tomorrow.

Yeah, I heard.

Well, I wanted
to throw him a
party or something,

but Austin's
his only friend,

and his folks are
taking him skiing

for the weekend.

Get him a clown.
Yeah, good idea.

What's wrong
with a clown?

Kids love clowns.

CARTER:
Okay, next time,
just inject 5cc's

of sterile fluroscein

and observe
under a woods lamp.

I wasn't sure about
the fluroscein.

Well, then come find me.
Don't just wait, okay?

I didn't want to
interrupt the meeting.

Neela, we were ranking

fourth year med students
in there,

and everybody agreed
that you're really bright,

and we really like
working with you.

Someone spoke
poorly of me?

Well, nobody in particular.

Was it Dr. Chen?

Because she's had it
in for me...

Neela, you have
to be more decisive.

Okay, you have to be more

proactive.

They feel I'm too passive?

Tell you want--

for the next four hours,
you are a doctor.

I want you to carry a minimum
of three patients at all times.

LOCKHART:
Rescue 37,
county base, go ahead.

Start their workups,
order the labs and meds,

and present back
to me only after

you've put your
own diagnostic
plan into action.

Today, you're a shark.

Shark?

Keep swimming,

or you die.

Car versus nursing home
medi-van.

We're getting the driver
and at least two passengers.

Anybody unstable?

Good vitals on all of them,
ETA nine minutes.

I've got the first.
Okay.

Okay, so work up these three.

In fact, just work up
these two. That's enough.

And then go help Gallant.

PRATT:
Hey, Mike...

( sighs )

...I'm leaving that stripper
in curtain four

with the broken toe
just for you.
Try not to TUBE her.

What? What are
you talking about?

Totally Unnecessary Breast Exam.

I think you're projecting.

Oh, Michael, hi.

New onset seizure needs
to go to medicine,

post-op appy with
fever needs a belly CT.

Call me if there's
a problem.

Got you.

You feel like buying
me some breakfast?

Maybe another time.

Deb, there's a lady
waiting for you in Triage.

Gallant can take her.
Uh, it's not
a patient.

She's a nurse.
She says she
works for you.

Have a good shift, Neela.

Lucia?

I'm sorry to bother
you at work.

Did something happen
with my dad?

No, the night nurse
agreed to stay late.

I'm not coming back.

Your father won't
wear the diaper,

he throws food at me.

When I try to
help dress him,

he yells very
bad words.

I-I appreciate your patience.

( sighs )

You know, this isn't really him.

I know he's a
very good man,
Dr. Chen, but,

I can't do it anymore.

Look, if you could just
give me a few days

until I can get a replacement?

Here is my address.

You can send my
last check there.

And give him
this for me.

Lucia...

I pray for him.

I don't like working
on old people.

Or children.
Or drunks.

And what's
with all the sick people?

They make it such a drag, huh?

Listen, he's just
motivating you.

For the match rankings.

You know, maybe
they're right.

Maybe this job's
just too...

fast for me, too
unpredictable.

It's a big hospital.

If the ER's not a good fit...

Then what?

The NICU made me want
to jump off the roof.

Pedes is filled
with screaming brats

and anxious parents.

And OB/GYN's a
lifetime of overnights

and malpractice suits.

I could go into
research or teaching,

but is that really why
I became a doctor?

I'm sorry.
Were you talking to me?

( laughs )

This-This place is so
up-and-down.

I mean, you learn
to ride through the rough days.

I did.

You were probably
good from the start.

Are you kidding me?

I came in young,
dumb and scared.

At least you--
you're good with the books.

You really
like it here?

I wouldn't stay if I didn't.

MAN:
Luis Sanchez, MVA passenger.

Deformed upper right leg,
probable femur fracture.

Oh, ouches. Don't!

You give anything
for pain?

Pressure's too low--
90/70.

He's from a nursing home?

Make it stop. It hurts.
Is this a change
in mental status?

I don't think
it's from the crash.

Nursing home said
he fell off a roof in December.

Can you call my wife?
I have a wife.

I think he's got

some kind
of traumatic brain injury.

Lower extremity fracture
with borderline pressure.

Need to rule out
an intra-abdominal bleed.
Trauma one.

Two more MVA's rolling
in behind.

( pained wailing )
Okay, on my way.

Can we medicate him?

Once his pressure's up.

LOCKHART:
Here's the SonoSite.

Two liters of saline
wide open.

Maybe we can draw up analgesics?

Luis, do you have
any allergies?

I don't know,
I don't know.

Are you taking any medications?

Mary gives me my pills.

What kind of pills?

A blue, a green,
and three white.

Okay, Morrison's
looks good.

No blood in the belly.

Pressure's up to 100.
Can we push morphine?

We need a med list
and allergy history first.

Call the home.
Make it stop!
It hurts!

Pocket Doppler
and Surgilube for
the pedal pulses.

I don't like.

Cole's potassium is 3.2.

40 of K-Dur p.o.

Suze, I'm
not going
to do it.

Then he's going
to press charges.

I have a couple
of other things.

Hey, we're the ones
who should be pressing charges.

Yes, this is
Neela Rasgotra
from County.

For what? Having a uniquely
disturbing pick-up line?

I need to speak to a nurse
taking care of a Luis Sanchez.

I believe the name's Mary?
Just say
you're sorry.

They're done
patching up
your freak.

Give a half bolus,
seven per kilo IV.

When will the nurse
be available?

Can you read me the list
from the chart then?

Why not?
Can Mrs. Herrero eat?

Two gram sodium diet,
1800 calorie ADA.

I'm sorry
you've had a bad morning, sir,

but Luis Sanchez has had
an even worse one,

so could you please
fax us the med list

as soon as possible?

( screams )

How about a magician?

Magicians are cool.

Last year he wanted
a pig embryo to dissect.

You really think
a magician's gonna do it?

Lucy Kilmer, another van
passenger from the nursing home.

History of laryngeal cancer,
complains of low back pain.

Where was she sitting?

Middle row, belted.

Vitals good,
resps 12.

Any belly pain, ma'am?

No. I'm okay.

Carter needs some help
with the van driver.

I have just the thing
for him-- paint ball.

Good idea, put a
gun in his hand.

50 more of fent is in.

Flail segment on the left
with hemo pneumo.

Betadine and size eight
sterile gloves.

What do you need?

Tachy at 126.
The guy next door
needs meds

but we have no drug
records or reliable
medical history.

Call the nursing home.
I did.

They're going to get back, but I
doubt it will be very quickly.

You tell them it was urgent?

They seemed very disorganized.
I'll need

a second thoraseal
on the other side.

Mr. Joss, do you keep paperwork
on the patients you drive?

He's not breathing.

Give me some in-line traction
and let's get ready to bag him.

Need a doctor in here.

The lady's having trouble
with her trake.

Ten blade,
and a 32 French.

Neela, go with Sam.

BP holding at 106 systolic,
sats still 91.

Okay, bag him up.

Her trake is out.

She must have
just pulled it.

She needs a new one.

Number four
shiley, uncuffed.

Okay, I'll call a doctor.

No, no, I can do it.

You need some Surgilube.

Right.

Okay, ma'am,
extend your neck

and look up
at the ceiling.

On your third breath.
Ready?

In, out.

In, out.

Big breath in...

( inhales deeply )

( coughing )

Pulse ox is coming up.

Let's tie it in.

Got it.

Thank you.

Doctors?

We don't need
no stinking doctors.

Neela!

She could use some ice chips.

Sats are coming up.

Transport information
on the passengers.

Found it in his jacket.
Go. Go!

Into the pleural space,
chest tube's in.

Systolic's up to 120
after two liters.

I've got the discharge summary
from the last hospital visit.

Okay, when was it?
Three weeks ago.

Good. Good enough.

Dr. Gallant, Mr. Anderson
is vomiting blood in CT.

Okay, titrate morphine to pain,
start with four milligrams.

Hemocue's 15, I don't think
he has any internal bleeding.

Stop. Not the morphine.

Violent nausea
and vomiting with morphine

during his last
hospitalization.

What do you want to do?

I'll be right back.

LEWIS:
Jerry, tell him.

It is not unmanly
to apologize.

Come on, just do it
and let's get out of here.

I'm exhausted.

Okay, okay,
I'm going in.

Did Dr. Gallant go to CT yet?

Yeah, he's already
down there.

Has there been a fax for me?

Were you waiting
on a price list

from Crazy Joe's
Party Supply?

Yeah, who knew piñatas
were so pricey?

Damn it.

Is everything
okay, Neela?

I've got it taken care of.

Neela,
Mr. Lavecchia's

urine is four plus for blood.

Uh, kidney stone.
Push 30 of Toradol.

I pulled Demerol.

No, give the Toradol 15 minutes
to work before we try narcotics.

All right, I'll put it away.

No, I'll take it.

( groaning )

Pain scale eight out of ten.

We need to give him something.

The discharge
summary says

he got post-op Demerol
in the hospital.

Good. How much?

Abby, triple lumen CVP kit?

Go ahead.
I'll take care of it.

Oh, please...

Please stop hurting...

Please.

All right, Luis, this is going
to make you feel much better.

( crying )

It's so sweet
to see them growing.

Babies?

Men.

Dr. Lewis, Mr. Hemorrhoid
in Three is asking for you.

Oh, no, I'm not here.
I left an hour ago.

( loud crash )
Crazy bastard!

Get off me!
Pull his hair!

Ow!

Chuck, stop!

Kick him!

Oh, my God!

( laughing )

Stop it, Chuck.

Get your hands off me.

Come on,
come on, guys.

Come on, Chuck.

Okay.
All right, all right.

It don't hurt no more.

You made it go away.

Isolated femur fracture
awaiting ortho.

No evidence of
occult blood loss,

vitals stable,
medicated for pain.

Good. Wheezing in two,
sudden onset visual loss

in the eye room.
Which one should I take?

Both.

Keep it up.

I never touched the guy.

He says you handled him
in an aggressive manner.

She handled him?
In his dreams.

There are a number
of potential lawsuits here.

Oh, you gotta
be kidding me.

In addition to the hospital
and the Emergency Department,

he's threatened to sue
the city, the county
and the Fire Department.

I'm not even
on duty.

I need this
to go away.

So either I get the lawyers
down here or...

No, fine,
I will talk to him.

What? No. No.

He's weird, not nuts.

I will talk some sense into him.

The hernia's trapped outside
the abdominal wall.

Is that bad?
You ready to round?

Deep breath, Bobby.

( inhales deeply )

Better?
Yeah, thanks.

A surgeon will come see you.

It's a straightforward
procedure,

nothing to worry about.

Cool.
Inguinal hernia?

Incarcerated.

Reduced without sedation--
the kid's tough.

20-year-old asthmatic,
came in with a sat of 89.

On his third albuterol with
atrovent, received 60 of pred.

Aeration's improved
but still 92 on room air.

Did you call medicine?

They're on their way.

Can I get
some more water?

Tigerlilly Lee, 24,
complaining of cotton mouth.

I'm like parched
all the time.

History of polydipsia led me
to check her blood sugar-- 642.

New onset diabetes,
not DKA'ing yet.

You should give ten...

Ten units of regular insulin,

two liters of saline
and I consulted endocrine.

Back to bed.

Hey!

( quietly ):
Very good.

She's looking much better.

Yeah, back to her usual self.

Viral gastroenteritis.

I consulted Kovac,
as you were too busy.

Thanks for your help,
doctor.

Mr. Silvio,
four ounces every hour,

and don't let her chug 'cause
she'll just throw it back up.

Oral rehydration,
avoided an IV,
in and out in an hour.

The girl is on fire.
Yeah, you told us so.

I told you so.

Told you what?

Nothing.
Attending gossip.

Hey, did you check out
the van driver?

Uh, yes. He needs an
exploratory laparotomy.

We're moving him up.

So?

His lungs re-expanded,
350cc's out the left tube...

No, no, no, no.
Not that.

Last night, the surgeon.

Oh. Uh, it was...
splendid.

Is that British
for "sweaty and hot"?

I don't kiss
and tell.

Abby, radiology's bouncing back
your patient.

Temp's up
and he's unresponsive.

I'm gonna need
some dirt later.

Our gift shop sucks.

You couldn't
find anything?

The best I could do
is a novelized version
of the Matrix Reloaded.

I had them fax over a
menu so you could see.

"Mr. Hyde's Tavern."

It's a haunted
mansion restaurant.

Strawberry bloodshake?
Tarantula fries?

That's cool, right?

I want it to be something he'll
remember, something special.

What, a bloodshake's
not special?

This is Frederika Torrez.

Hurt her ankle during tennis
team practice.

Who put this on?

Sister Margaret.
Um, she's my coach.

Did she come with you?

Yeah, she's out
in the waiting room
with the other girls.

Did you roll it
inside or out?

Uh... I can't really remember.

SAM:
The toenail's bruised.

Did you do anything else
besides twisting it?

I don't think so.

Are you sure you didn't jam
your toe, or kick something?

Okay, there's this
really creepy guy

who keeps on flashing us
during practice

from outside
the fence.

You know, opening his coat

and he's naked underneath.

I mean totally.
It's really gross.

Yeah, I bet.
Sister Margaret
called the cops

last time, but he got away
before they showed up.

Uh-huh...

So today we just
got sick of it,

and we all ran out after him.
Got some pretty good whacks in
before he got away.

You beat this man up?

Sister Margaret
also teaches us
self-defense.

She's cool.

How bad did you hurt him?

I'm pretty sure
we kicked his ass.

Need a little help here.

He's unresponsive,
temp's 105.8.

He didn't have a fever
before. Luis? Luis.

He needs a septic workup.

CBC, blood cultures times two,
cathed UA, and do a spinal tap?

Yeah, rule encephalitis
and meningitis.

Oh, no.

All right, roll him.

You want Ativan?
Four migs.

Come on, push it.
Is he on aphenothiazine?

What does the medical
record say?

I'll see if it came in.

You didn't get it yet?

Doctor, the headache's worse.

I'll have the nurse give you
another shot.

Did you look
at my X-rays yet?

Soon, Mrs. Jenkins.
Hey, slow down, girl,

you're showing us all up.

Luis Sanchez
is seizing.
Who?

Brain injury guy
from the nursing home.

I thought he was stable.
Not anymore.

Six of ativan on board.

And load a gram
of dilantin.

I've got the
med list.

Why didn't you
have it before?

The fax wasn't in.
The driver's transfer record
was only three weeks old.

All right,
read it to me.

Baclofen, Omeprazole,
Keflex, Tolterodine.

The only thing new is they
switched his antidepressant

two weeks ago-- Phenelzine?

It's a monoamine
oxidase inhibitor.

What'd you
give him?

Morphine.
All right, we
need to start

thinking about
an airway.
No, Demerol.

You gave him
Demerol?

He had nausea with morphine,
so...

Oh, God, it's
serotonin syndrome.

What?

You never give Demerol
with an MAO inhibitor.

It can be fatal.

Let's get him on O2
at 15 liters.

Spinal tap,
come on.

Prep and drape!

WEAVER:
Your better half got that idiot

to drop the whole thing.

She did?

What do we have to do?

You don't have to do anything.

Do you mind if I lift your shirt
up a little bit?

Don't push your luck, creep.

( mouthing words )

Don't worry. I'll get Chuni
to put battery acid in his IV.

Hey, Jerry, will you check
on my X-rays?

What's up with you?

I defended Susan
from some freak.

And ended up getting
her molested.

I can't watch this anymore.

George Deakins, mugged under
the Michigan Avenue bridge.

Lovely spring day.

You'd think you could
take a walk by the river.

Okay, Mr. Deakins, could you
remove your coat, please?

I'd rather not.

In order to examine you,
I need to listen to your chest.

It's all right, George.

Whoa, they steal your clothes?

Uh, yeah.

Okay, get him a drape.

Cocktail napkin
ought to do it.

So, they scratched you up
pretty good.

How many guys
were there?

Must have been

like four or five.

With long nails...
and a tennis racket.

So, George...

You a sports fan?

Fluid looks clear.
B.P.'s sky high,

220/140.
Start an esmolol drip.

Hypertension
part of the syndrome?

Who pushed the
Demerol for you?

They should've
verified.
Nobody. I did.

There was no nurse?

I was called
out of the room.

It's not Abby's fault.

I'm more than capable
of pushing pain meds.

Shouldn't push anything
without medical history.

Didn't want to wait for the
nursing home-- he's in pain.

Who did you speak to,
by the way?

The receptionist.

Oh, so you didn't actually talk
to a doctor or a nurse.

Dr. Carter...
I couldn't.
They were busy.

No. What you can't do
is take no for an answer

when you have an unstable
patient with an unknown history.

I gave her the order.

I thought you said morphine.

Neela saw
it was contra-indicated,

so I changed it to Demerol.

Then what, you forgot?

I was a bit preoccupied.

Had someone crashing
in C.T.
Dr. Gallant...

Myoclonus
and hyper-reflexia.

Isn't there
a serotonin antagonist

we can give him?
No. We just
have to wait.

For what?

To see if he lives.

DEAKINS:
When can I go?

You have to talk
to the police first.

The police?

About my mugging?

Yeah.

Still haven't left?

I don't want to talk about it.

I'm going to kill you.

Baby, please,
I am sorry.

Listen, please...

How does a guy like that
get to be such a freak?

Born with a Y
chromosome?

Oh, so all men are twisted?

LEWIS:
You said it.
You hate men.

If it wasn't for
sperm and heavy lifting,
you'd all be useless.

You know, I can't
wait to pop this baby
out so men'll quit

looking at me either
like I'm Mother Teresa
or the cover of Maxim.

It's not just men-- come on,
the world's full of degenerates.

Yeah, and the sad part is
they always get away with it.

( screaming )

Temp's still up, 104.

Another 200 of
I.V. dantrolene.

How come there's
no written order
on this chart?

We were busy--
I called it out on the run.

Demerol, 50-milligram
I.V. push,

verbal order, 10:23.

Dr. Gallant, can I speak
with you for a moment?

Sorry, you're right.
It's more like 10:45.

Pulse ox down to 82.

He's not moving any air.

Too much ativan?

Maybe, or neurologic
damage from the
hyperthermia.

Okay, let's open
an intubation tray.

Bag him on 100 percent,
andetomidate and sux.

His wife and daughter are here.

LOCKHART:
Suction's ready.

CARTER:
Call Respiratory
for a vent.

LOCKHART:
Sats are up to 89
with bagging.

Take 'em to the family room.

Neela, come on, come on,
you're doing the tube, let's go.

TAGGART:
Welcome to the perv ward,
Mr. Deakins.

You put me in a special room?

Don't worry,
they're all special.

Uh, pervert's a
relative term, honey.

Call me honey again,
I'll come over there

and give you the longest
catheter in the world.

KOVAC:
Neosporin to the lac,

B.I.D.

So, I've got our
problem solved.

Alex's birthday party.

Aw, thanks for the
help, Luka, but I
think it's my problem.

You see, that's
your first mistake.

Anyway, a plan is in motion,
arrangements are being made,

and everything
is under control.

Keegan's C.B.C. isn't back yet,
and I need a head C.T. on Hong.

Do me a favor, would you:
call United and check
on my departure time?

What, are you flying
through Paris?
Amsterdam.

Hello?

Frank.

Hey, Frank.
What's up? How are you?

Just thought I'd
stop by on my way
out from rehab.

How's that going?
How do you think?

They split my chest
open like a baked
Montana trout.

You don't just
bounce back, you know.

Want to see my scar?
No, but there's a guy in two
who might want to touch it.

You look good. You do.

I can do two miles
on the treadmill.

I haven't been able to do that
since... well, ever.

Where the hell
are my last two paychecks?

Ah, I've been
holding them for you.

Where, in your wallet?

When are you coming back?

I don't know, you know?

Rehab's like a spa vacation.

My old police benefits
are a charm.

I don't really miss
this sideshow.

Is Dr. Pratt around?

He's off today.

Tell him I owe him a beer.

Sure thing.

Look...

my doctor's not
ready for me to come
back to work yet.

It's going to be
awhile, but... I
do miss everybody.

Just wanted to say that.

Four-year-old with left
upper quadrant pain.

Found by father with shortness
of breath and confusion.

He kept asking for me
even though I was... I
was standing right there.

It was like he
couldn't see.

Tachy at 144, resps 42.

B.P. 86/55.
Hey, big guy,

when did your tummy
start hurting?
No, Mommy, no.

She's on her way, buddy.
He's not making any sense.

Any medical problems?

No, he's always
been healthy.

77 systolic.

How are you doing,
Tevin?

I don't like horses.

He's altered. Have a pedes
intubation tray ready

and squeeze in
those fluids.

Hey, do you know
what this is?

Your son's spleen

is enlarged-- it may be acting
like a sponge,

soaking up his blood
so it can't circulate.

So, what can you do to stop it?

Hopefully, transfusions

will keep him stable
until we know what's causing it.

First liter in,
pulse in the 70s.

Okay, keep the N.S. coming.

Femoral line kit.
I'm with him every day.

I-I-I-I take
care of him.

Nothing like this
has ever happened.

Does your son have
a history of Thallassemia
or sickle cell disease?

My wife has the trait,
but I tested negative.

I want to go
on the ferris wheel.

Okay, as soon as
you're better, buddy.

I-I-I don't know what
that other thing is.

Thallassemia?
It's a hereditary anemia.

Here you go.
Huh?

Keep talking to him--
it's the best thing

you can do right now.

Blood's here.
Femoral line's in.

Run them on the infuser.

You think it's
occult trauma?

Should we call
in Social Work?

I don't know. It could be
malignancy, emoglobinopathies...

That's some
differential.

Yeah. Add a sickle screen
and HIV to the labs.

We didn't realize Luis was
recently put on phenelzine.

There's an interaction
between the drugs

that creates a condition
known as serotonin syndrome.

You get very sick.

Like when they gave him
the morphine that time?

Uh, worse.
You get high fever,

high blood pressure,
rapid heart rate,

muscle spasms.

How long does
that last?

A few days at least.

But it's very serious.

Up to 30 percent of people with
serotonin syndrome die from it.

So 70 percent survive?

Yes, ma'am.

They didn't think he'd ever wake
up after the fall, but he did.

Good. Good. That means
he's a fighter.

He's really smart, you know?

I mean, he was going
to go back to school
before the accident.

Then I got pregnant again.

My dad hired him
on at his roofing
business.

They don't usually
work when it's icy,

but there was a job

that he wanted to
finish before Christmas.

Why are you saying
you did this?

It doesn't change anything,
and I'm partially to blame.

And that makes
it okay to lie?

Neela, do you want to match,
or don't you?

Only if I deserve to.

You do, so let this
be my fault.

Hey, patellar
dislocation in curtain
four needs a reduction.

How's Luis?

He's, um... he's stable.

It's looking
pretty good.

Is there something that
I should know about?

No.

All right, well, you
did what you were told.

Gallant's a
supervising resident.

He should've known
better than to
order up a drug

without verifying
a current medical
history.

He didn't. I did.

You ordered the Demerol?

I assessed it. I ordered it.
I pushed it.

And you didn't run
it by an attending
or a resident?

No.

And you did it
because I asked you

to be more autonomous?

We found an Arabic interpreter

for your belly pain lady.

Thank you. All right,

we need to talk about
this-- the three of us.

Everything okay?

Fantastic.

Oh, Lavecchia's results.

Kidney stone
from this morning?

No hydro, pain free with Toradol
and ready to go home.

Just like you said. Didn't need
the Demerol after all.

You still have the vial?
Put it back in drug lock-up.

I used it for
another patient.

KOVAC:
Sam, did you get labs back
on Tevin?

How's Tevin doing?

He's doing much
better, thanks.

I want to go home.

Mr. Walker...

Hey, you want to pick out
a sticker?

Tevin tested positive
for, uh, sickle cell anemia.

That's impossible--
I told you, I don't
carry the gene.

Maybe there was a mistake
with your test.

Maybe there was a
mistake with your test.

What your son has--
splenic sequestration--

is consistent with sickle cell,
and I think he has a form

that's very...
You're not listening.

I told you, I went to
a genetic counselor.

He said I'm not a carrier,
that our son could not get

the disease
unless both parents are.

That's true.

So, what, you're saying
I'm not his father?

What I'd like to do
is send his blood

for a more advanced test...
just to be sure.

Send my blood, too.

Test me again.

Neela... Carter
wants to talk to
me after my shift.

I told him what happened.
You what?

I didn't think it was right
for us to lie about it,

so I thought it'd be better
to get it out now.

Nobody needed to
know, Neela-- that
was kind of the point.

Please, someone! Please help!
Something's wrong!

He went into v-tach,

unsuccessful cardioversion
at 200.

Get him off the
vent and bag him.

Please, he can't be dying.

Charged to 300. Clear.

No change. Try 360.

Need any help?

Amp of epi
after the next one.

MARQUEZ:
Charged.
Clear.

V fib, 100 of lidocaine.

This is not supposed
to happen.

Go find Dr. Carter now.

Let's go, 360 again.

Clear.

Come on, hit him
again. 360.

MARQUEZ:
Clear.

GALLANT:
Still in fib.

CARTER:
All right, 360
again. Clear.

Asystole.

How long has it been?

Should we try the
high dose epi?

42 minutes.

Run the dopamine
wide open.

We still have time.

Or we can pace him.

Neela...

Let's try pacing him.

WEAVER:
Tie off the lines,

leave the E.T.
for the coroner.

Carter, go inform the
family and then meet
us in the suture room.

Are his tests back?

They, uh, confirmed
my diagnosis...

but the good thing is
most kids do very well

with folate and
prophylactic antibiotics.

Good. That's good.

I, uh, also ran
your blood through.

The tests indicate that...

Is there anything
affecting my health

that I need to know about?

Not really, no.

So all that piece of paper
is going to tell me

is whether or not
he's got my genes.

Either way,
he's still my son.

I'm his father.

From a medical standpoint,
it's a bit more complicated...

Liza... my wife and I--

we, um... we went
through a rough patch

about five years ago.

We broke up
for a few weeks.

She got pregnant right after
we got back together.

We've been happy ever since.

She's going to want to know
about Tevin's condition.

Mm.

I'll tell her
that I'm a carrier.

He got it from both of us...

and he's going to be okay.

He's in here,
Mrs. Walker.

Honey, is he all right?
He's fine, he's fine.

Did you get
his labs back?

( sighs )

Is he the father?

Yeah.

Hey, uh, I didn't
mean to keep ragging

on your suggestions before.

Maybe Mr. Jekyll's
isn't such a bad idea.

Mr. Hyde's.

Look, I... I know I'm
not exactly Carol Brady,

so I just really wanted
it to be something special.

It will be.

Just be ready to go
in half an hour.

I have to pick something up,
okay?

Was the med list current?

Kerry, I think
we should stick to protocol.

As the Attending,
I'd like to have a chance

to review the case
with my staff before we do this.

Was the med list
current or not?

It was recent.

It wasn't completely up to date.

And no one checked
with the nursing home?

I tried.

You tried?

Abby, why didn't you
push the meds?

I was called out of the room,

but the result wouldn't have
been any different.

As the nurse, it's
your responsibility

to double-check

allergies and interactions.

I thought
that had been done,

to the best
of anybody's ability.

This is a case of trying
to manage a patient's pan

with incomplete
information.

I suspect a jury
isn't going to see it that way.

Who made the decision?

I did.

You did?

So now we let medical students
push pain meds

without any supervision?

No, that's not what happened.

CARTER:
I was with
a critical care patient.

Neela did exactly
what I told her to.

Actually, that's not...
She's just trying
to protect me.

Do you all need a few
minutes to get your
stories straight?

What does it say on the chart?

Exactly what I've been saying.

I ordered up the drug
and Neela pushed it.

And is that accurate?

Like I said,
I wasn't in the room.

Simple question--
Is it accurate?

As far as I know, yes.

A young man comes in here

and dies
of a lethal drug reaction

that could have
been prevented

with one phone call.

Next time, why don't we
just send a blank check

to the family's attorney?

SAM:
Mom.

Mom.

Son of Sam is back.

What are you doing here?

Luka picked me up.
It's amazing.

We gotta go, though.
We gotta go.

Hold on.
MARQUEZ:
I'll take those, Sam.

Come on. If we hurry now,
we can get there by 11:00.

What are you
talking about?
Let's go, let's go.

And what are you wearing?

Luka said
I have to wear a life vest

if I want to get
on the boat.

SAM:
Boat?

Isn't it awesome?

It's, like, bigger
than our whole apartment.

Wow, you really went
a whole other direction.

A weekend in the
great outdoors,

fishing, camping,
burning s'mores.

S'mores?

Do you even know
what that is?

Yeah, that white
thing on a stick.

Come on, you got
to see inside.

Wait, where are we going?

I rented a spot
at Lake Geneva.

Bottom of the ninth,
two outs, nobody on

and here comes Kovac
with the clutch homer.

Is that baseball?

Mm-hmm.

( horn honking )

How are you going
to back this thing out?

Mr. Joss' triple-A
repair went well.

He's stable in the ICU,

and Dr. Edson's
finishing up

on the perirectal abscess
right now.

Uh, and do you know
a cheap red wine

that goes with spicy food?

I have a date.

Two nights in a row?

It's with
the teacher tonight.

Okay.

Zinfandel.

I'm not completely comfortable
with waking up with one man

and going out with another
the next night.

Well, if we were guys,

we'd be talking about
carburetors right now.

So, you don't think
it's... slutty?

No.

I just won't sleep with him.

That sounds
like a good plan.

Good-night.
Good-night.

Women plan, God laughs.

Hey, when did I become
the guru of sluttiness?

Did you start
the banana bag on Vern?
Three times.

He keeps going off
to the bathroom and
coming back drunk.

I think I should delete
emergency medicine

from my match list.

It was one mistake, and
I pushed you too hard.

No.
What they said about me

in your meeting
was all true.

Look, you're a talented doctor,

and you did a lot of good
things on the shift today.

Nothing I did on this shift
can convince me,

or anyone else,
that I belong here.

Well, yesterday, you were
a little too cautious.

Today, you were a
little too reckless.

Somewhere in the middle

is the way to practice
emergency medicine.

I just want you to know

I shouldn't have left you
alone with the patient

until he was stable.

It's my fault.

What you did was the sweetest,
dumbest thing

anyone has ever done
for me.

Well, something like this

could've derailed
your career.

The worst that'll
happen to me is...

discipline, counseling.

I'll be all right.

You don't look all right.

Seems kind of silly now,

but out in the bay this
morning, I was, uh...

...was thinking
about asking you out.

I was thinking of saying yes.

Neela, I have the cefoxitin
for Mr. Martin.

I just need
the extension tubing.

( sniffles )

Are you okay?

I'm fine. I'll take care of it.

Let me help you find it.

I said I can do it!

Bottom drawer.

( crying )

Well, uh...
( clears throat )

I suppose it's time
to call it a night.

You're welcome to
stay a little while.

No, no, no.

I really should get going.

I'll get my coat.

I'll help you find it.

It was such a lovely evening,
and, uh,

I'm so glad that the
girls like each other.

Ella's a great kid.

Oh, and it was
really good of you

to pick her up
from school.

Thank you so much.

Uh, you want me to
carry her to the car for you?

No, no. No, I'm fine.

I can manage.

So...

good night.

CARTER:
You should've come
and talked to me.

You know why
I backed you up in there?

'Cause if Weaver
knew the truth...

you'd be done.

( clears throat )

I know you went out
on a limb for me, but...

I could just say
I got confused.

Yeah, you could've...

until you falsified the chart.

But...

That's a felony.

Okay... ( clears throat )

Well, then
I got to go tear it up.

It's too late.
Why? Why? Why?

It's just... it's just one entry

on an otherwise
blank order sheet.

Okay, nobody's going to
even know it's missing.

We can go talk to Weaver again.

It's too late!

It's already up in Legal.

You know, you guys...
you guys sit up there

and you decide who's going to
go and who's going to stay.

I mean,
why did you have to push her?

Hmm? Why'd you have to push her?

The only reason
she screwed up

is because you scared
her into thinking

she wasn't good enough!

She wasn't cutting it!

( quietly ):
We're talking
about you now, Michael.

I wasn't thinking...

I'm sorry.

Yeah.

Me, too.